Privacy and Trust in pHealth - Past, Present and Future

From beginning to today, pHealth has been a data driven service that collects and uses personal health information (PHI) for personal health services and personalized healthcare. As a result, pHealth services use intensively ICT technology, sensors, computers and mathematical algorithms. In past, pHealth applications were focused to certain health or sickness related problem, but in today they use mobile devices, wireless networks, Web-technology and Cloud platforms. In future, pHealth uses information systems that are highly distributed, dynamic, increasingly autonomous, multi-stakeholder data driven eco-system having ability to monitor anywhere person's regular life, movements and health related behaviours. Because privacy and trust are pre-requirements for successful pHealth, this development raises huge privacy and trust challenges to be solved. Researchers have shown that current privacy approaches and solutions used in pHealth do not offer acceptable level of privacy, and trust is only an illusion. This indicates, that today's privacy models and technology shall not be moved to the future pHealth. The authors have analysed interesting new privacy and trust ideas published in journals, and found that they seem to be effective but offer only a partial solution. To solve this weakness, the authors used a holistic system view to aspects impacting privacy and trust in pHealth, and created a template that can be used in planning and development future pHealth services. The authors also propose a tentative solution for future trustworthy pHealth. It combines privacy as personal property and trust as legal binding fiducial duty approaches, and uses a Blockchain-based smart contract solution to store person's privacy and trust requirements and service providers' promises.